RESUMO
The epidemiometric model of leprosy, built on Polambakkam, India, data, is used to compare the impact on incidence of dapsone and different multidrug therapy (MDT) strategies. The simulations show that generalization of MDT could have a dramatic impact on transmission of the disease. Relapses after MDT, although important from an individual point of view, have a negligible influence on the incidence. Introduction of MDT requires investments that, during the first few years of the program, are much greater than for dapsone monotherapy. These are, however, rapidly absorbed due to the rapidly declining number of new cases, particularly when MDT is not limited to multibacillary cases but is administered to all patients.
Assuntos
Simulação por Computador , Dapsona/uso terapêutico , Hansenostáticos/uso terapêutico , Hanseníase/tratamento farmacológico , Análise Custo-Benefício , Quimioterapia Combinada , Humanos , Incidência , Hanseníase/epidemiologiaAssuntos
Hanseníase/epidemiologia , Adolescente , Adulto , Fatores Etários , Idoso , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores SexuaisRESUMO
Epidemiometric models are useful in studying disease dynamics in populations. Such a model was developed for leprosy and proved useful, but did not take into account age- and sex-specific incidence rates. This paper presents a new version of the model which makes provisions for age and sex differential rates according to the type of leprosy and which includes more realistic parameters for death rates, population variations, and natural growth rates. This new version of the epidemiometric model was used to stimulate the effects of various vaccines and drug resistance on the incidence of leprosy in a population.
